An example of a Narcan kit, which is used to administer naloxone to people who have overdosed on opioids(Photo: MNPD)

Cheatham County EMS Director Danny Schaeffer knew what a "Narcan party" was before he heard of them ever happening in Cheatham County. But over the past year, he's heard of them happening locally, too.

Such "parties," if they're occurring, may alter data on overdose deaths, a consequence of which Schaeffer worries could include preventing the county from receiving grants for the life-saving drug.

Schaeffer explained the so-called Narcan parties involve drug users “pushing their personal limits (to see) how high they can actually get. If something does take place … somebody is there to give them Narcan.”

“I don’t think it’s a common practice for all of your drug users, but I think it is something that has taken place here in Cheatham County and probably will take place again," he said.

Cheatham County Sheriff Mike Breedlove said in a text message that "we have no documented reports but are only hearing known addicts talking about them. With Narcan now available to the public, there is a probability that some addicts are using it and not contacting emergency services.

"I don't know if we're having any actual Narcan parties," Breedlove said later. "We hear it ...The purpose of (a Narcan party) is to prevent" a call to law enforcement. "It's just talk right now."

Tommy Farmer with the Tennessee Bureau of Investigation also noted Narcan parties at an Oct. 30 town hall meeting sponsored by the Cheatham County Community Enhancement Coalition.

"We have had this happen, having Narcan parties," Farmer said at that meeting. "There is absolutely no guarantee and assurance (of revival), and it is happening."

Schaeffer clarified that the goal of a Narcan party is not to reach the point of an overdose.

“Narcan parties are not where people are purposely overdosing because somebody has Narcan readily available and can bring them back,” he said, noting that drug users wouldn't usually want to use Narcan because it will “take their high away” and make them “dope sick (which is) very uncomfortable and painful.”

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One result, Schaeffer fears, is that fewer people will call 911 to report an overdose — although overdoses are occurring — and that could impact the county's ability to get grants to provide Narcan to those who need it.

“I think it’s an issue for everybody involved,” Schaeffer said. “Now we have no way of knowing whether or not there was an overdose or not at a particular residence or happened to a particular person.

“Whoever’s in charge of the statistics (to provide grants) may say, ‘Y’all don’t really have a problem anymore,’” he said, although that may not be true.

Breedlove said he wasn't sure whether the skewed data could affect grants, but hopes the county still receives funding for Narcan in the future.

"We want the Narcan out there for family members," he said. Narcan administration could mean "the difference between life and death before we get there."

How many overdoses in Cheatham County?

Cheatham County EMS data show there were 15 overdose deaths in the county in 2018, more than the previous year. In 2018, 177 doses of Narcan were administered to 138 patients, some of whom needed more than one dose.

Schaeffer said the heroin and fentanyl overdose numbers “skyrocketed” between 2017 and 2018, which surprised him “quite a bit.”

Breedlove also deemed those figures "alarming."

In 2017, there was one death in which the toxicology report contained fentanyl, and two deaths showing heroin. Last year, however, nine included fentanyl and seven included heroin.

“That’s a pretty big spike,” Schaeffer said. That data suggests to him “that the overdoses from prescription medications I think have kind of plateaued,” for which he credited changes in requirements for doctors prescribing medication. But when it’s “harder for these folks to get prescription medications, (they’re) turning to the streets,” he said.

In 2017, Cheatham County EMS recorded 149 overdoses, including 12 overdose deaths. Of the 149, there was one heroin, two fentanyl and six other opiate overdoses confirmed throughout the year, according to a previous USA TODAY NETWORK - Tennessee report.

The release said prescription opioids are still the most common drugs associated with overdose deaths in the state. It also notes that deaths linked to “street” drugs obtained without a prescription “were a key driver of the increase in overdose deaths in Tennessee (in) 2017."

'Narcan is saving lives'

Having Narcan on hand is also no guarantee an opioid overdose victim won't die, Schaeffer said.

“The risk would be that the Narcan wears off before the drug that caused them to overdose does, and they go into a second overdose and could die before we ever did get called,” he said. "(It’s a) very, very dangerous scenario.”

Breedlove said Narcan lasts for about 30 minutes. After that, the drug user could revert back into an overdose state if they haven't sought medical treatment.

Schaeffer believes that curbing the problem relies on continuing to educate the public, as well as providing long-term care for drug addicts to get sober.

Both said that despite the potential problem, having Narcan available to the public is a good thing.

“One thing is for certain,” Schaeffer said. “Narcan is saving lives … It’s a micro solution to a macro problem.

“I’m not against Narcan whatsoever, I just feel like sometimes people are looking at the Narcan as an end-all solution … really, it’s not.”